Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 12 , ISSUE 4 ( October-December, 2023 ) > List of Articles

Original Article

Evaluation of the Cardiac Status of Newly Diagnosed Chronic Obstructive Pulmonary Disease Patients at First Admission

Mustafa İ Bardakci, Müfide Arzu Ozkarafakili, Mutlu Cagan Sumerkan

Keywords : Cardiovascular disease, Chest, Chronic obstructive pulmonary disease

Citation Information : Bardakci Mİ, Ozkarafakili MA, Sumerkan MC. Evaluation of the Cardiac Status of Newly Diagnosed Chronic Obstructive Pulmonary Disease Patients at First Admission. Indian J Respir Care 2023; 12 (4):308-314.

DOI: 10.5005/jp-journals-11010-1074

License: CC BY-NC-SA 4.0

Published Online: 18-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Objective: We aimed to detect possible cardiac pathologies early by cardiologically evaluating patients newly diagnosed with chronic obstructive pulmonary disease (COPD). Materials and methods: The study included 69 newly diagnosed COPD patients who came to our outpatient clinic and 39 individuals who had smoked for at least 20 years. Both groups were evaluated in chest diseases and grouped according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and then evaluated in the cardiology outpatient clinic. Results: Of the COPD patients included in the study, 49 (71.01%) were male, and 20 (29.99%) were female. The COPD patient group was divided into three groups based on the 2023 GOLD strategy report. There were a total of 38 (35.2%) patients in the GOLD-A group, 28 (73.7%) male and 10 (26.3%) female. The right branch block was seen in 15 (13.9%) of all participants. A total of 14 of them were in the COPD group, and one of them was in the control group. Of the COPD patients with right branch block, 10 (26.3%) were in the GOLD-A group, three (12.5%) were in the GOLD-B group, and one (14.3%) was in the GOLD-E group. Diastolic dysfunction was seen in 38 (55.1%) COPD patients and 14 (35.9%) control groups. Of the patients with COPD with diastolic dysfunction, 22 (57.9%) were in the GOLD-A group, and 20 (55.3%) of them were in grade 1. Mitral valve disease was detected in 19 (27.5%) of the patients with COPD, tricuspid valve disease in 18 (26.1%), and aortic valve disease in two (2.9%) patients. Conclusion: We have seen that a significant number of our patients have started their cardiological pathologies during the initial diagnosis. With this strategy, cardiac pathologies can be intervened early, and better results can be obtained in the management of COPD.

PDF Share
  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management of chronic obstructive pulmonary disease. (2023 Report). Available from:
  2. Celli B, Fabbri L, Criner G, et al. Definition and nomenclature of chronic obstructive pulmonary disease: time for its revision. Am J Respir Crit Care Med 2022;206(11):1317–1325. DOI: 10.1164/rccm.202204-0671PP
  3. Türk Toraks Derneği KOAH Çalışma Grubu. Kronik Obstrüktif Akciğer Hastalığı Tanı ve Tedavi Raporu. Turkish ThoracicJournal 2014;15: Suppl 2.
  4. Huertas A, Palange P. COPD: a multifactorial systemic disease. Ther Adv Respir Dis 2011;5(3):217–224. DOI: 10.1177/1753465811400490
  5. Yellowlees PM, Alpers JH, Bowden JJ, et al. Psychiatric morbidity in patients with chronic airflow obstruction. Med J Aust 1987;146(6):305–307. DOI: 10.5694/j.1326-5377.1987.tb120267.x
  6. Schnell K, Weiss CO, Lee T, et al. The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999-2008. BMC Pulm Med 2012;12:26. DOI: 10.1186/1471-2466-12-26
  7. Ezzati M, Lopez AD. Estimates of global mortality attributable to smoking in 2000. Lancet 2003;362(9387):847–852. DOI: 10.1016/S0140-6736(03)14338-3
  8. Crisan L, Wong N, Sin DD, et al. Karma of cardiovascular disease risk factors for prevention and management of major cardiovascular events in the context of acute exacerbations of chronic obstructive pulmonary disease. Front Cardiovasc Med 2019;6:79. DOI: 10.3389/fcvm.2019.00079
  9. Brassington K, Selemidis S, Bozinovski S, et al. New frontiers in the treatment of comorbid cardiovascular disease in chronic obstructive pulmonary disease. Clin Sci 2019;133(7):885–904. DOI: 10.1042/CS20180316
  10. Shen YC, Chen L, Wen FQ. [Inter[retation of 2019 Global Strategy for the Diagnosis, Management and Prevention of chronic Obstructive Pulmonary Disease]. Zhonghua Yi Xue Za Zhi 2018;98(48):3913–3916. DOI: 10.3760/cma.j.issn.0376-2491.2018.48.001
  11. Sabit R, Bolton CE, Fraser AG, et al. Sub-clinical left and right ventricular dysfunction in patients with COPD. Respir Med 2010;104(8):1171–1178. DOI: 10.1016/j.rmed.2010.01.020
  12. De Miguel Diez J, Morán Caicedo L, Rodríguez Rodríguez P, et al. COPD as a cardiovasculer risk factor. Aten Primaria 2012 Mar 5. [Epub ahead of print].
  13. Li XF, Wan CQ, Mao YM. Analysis of pathogenesis and drug treatment of chronic obstructive pulmonary disease complicated with cardiovascular disease. Front Med (Lausanne) 2022;9:979959. DOI: 10.3389/fmed.2022.979959
  14. Deshmukh K, Khanna A. Implications of managing chronic obstructive pulmonary disease in cardiovascular diseases. Tuberc Respir Dis (Seoul) 2021;84(1):35–45. DOI: 10.4046/trd.2020.0088
  15. Chen Y. Interpretation of global strategy for the diagnosis, treatment, management and prevention of chronic obstructive pulmonary disease 2022 report. Chinese Gen Pract 2022;25(11):1294–1304. DOI: 10.12114/j.issn.1007-9572.2022.01.302
  16. Türk Toraks Derneği. Türk Toraks Derneği'nin GOLD 2021 Kronik obstrüktif akciğer hastalığı (KOAH) raporuna bakışı. İstanbul: Optimus Yayıncılık, Nisan 2021.
  17. Standardization of spirometry: 1994 update. American Thoracic Society. Am J Respir Crit Care Med 1995;152(3):1107–1136. DOI: 10.1164/ajrccm.152.3.7663792
  18. Wanger J, Clausen JL, Coates A, et al. Standardization of the measurement of lung volumes. Eur Respir J 2005;26(3):511–522. DOI: 10.1183/09031936.05.00035005
  19. Mitchell C, Rahko PS, Blauwet LA, et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2019;32(1):1–64. DOI: 10.1016/j.echo.2018.06.004
  20. Galderisi M, Cosyns B, Edvardsen T, et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2017;18(12):1301–1310. DOI: 10.1093/ehjci/jex244
  21. Baum C, Ojeda FM, Wild PS, et al. Subclinical impairment of lung function is related to mild cardiac dysfunction and manifest heart failure in the general population. Int J Cardiol 2016;218:298–304. DOI: 10.1016/j.ijcard.2016.05.034
  22. Lipworth B, Skinner D, Devereux G, et al. Underuse of β-blockers in heart failure and chronic obstructive pulmonary disease. Heart 2016;102(23):1909–1914. DOI: 10.1136/heartjnl-2016-309458
  23. Vestbo J, Anderson JA, Brook RD, et al. Fluticasone furoate and vilanterol and survival in chronic obstructive pulmonary disease with heightened cardiovascular risk (SUMMIT): a double-blind randomized controlled trial. Lancet 2016;387(10030):1817–1826. DOI: 10.1016/S0140-6736(16)30069-1
  24. Mesquita R, Franssen FM, Houben-Wilke S, et al. What is the impact of impaired left ventricular ejection fraction in COPD after adjusting for confounders? Int J Cardiol 2016;225:365–370. DOI: 10.1016/j.ijcard.2016.10.016
  25. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. Updated 2013. In. 2013.
  26. Fragoso E, Andre S, Boleo-Tome JP, et al. Understanding COPD: a vision on phenotypes, comorbidities and treatment approach. Rev Port Pneumol (2006) 2016;22(2):101–111. DOI: 10.1016/j.rppnen.2015.12.001
  27. Thomsen M, Ingebrigtsen TS, Marott JL, et al. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA 2013;309(22):2353–2361. DOI: 10.1001/jama.2013.5732
  28. Holtzman D, Aronow WS, Mellana WM, et al. Electrocardiographic abnormalities in patients with severe versus mild or moderate chronic obstructive pulmonary disease followed in an academic outpatient pulmonary clinic. Ann Noninvasive Electrocardiol 2011;16(1):30–32. DOI: 10.1111/j.1542-474X.2010.00404.x
  29. Schneider C, Bothner U, Jick SS, et al. Chronic obstructive pulmonary disease and the risk of cardiovascular diseases. Eur J Epidemiol 2010;25(4):253–260. DOI: 10.1007/s10654-010-9435-7
  30. Finkelstein J, Cha E, Scharf SM. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Int J Chron Obstruct Pulmon Dis 2009;4:337–349. DOI: 10.2147/copd.s6400
  31. Buklioska-Ilievska D, Minov J, Kochovska-Kamchevska N, et al. Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: echocardiography changes and their relation to the level of airflow limitation. Open Access Maced J Med Sci 2019;7(21):3568–3573. DOI: 10.3889/oamjms.2019.848
  32. Mohammed YM, ElShahid GS, Osman NM, et al. Cardiac evaluation of patients with chronic obstructive pulmonary disease using echocardiography. Egypt J Bronchol 2019;13(1):12–16. DOI: 10.4103/ejb.ejb_2_18
  33. Portillo K, Abad-Capa J, Ruiz-Manzano J. Chronic obstructive pulmonary disease and left ventricle. Arch Bronconeumol 2015;51(5):227–234. DOI: 10.1016/j.arbres.2014.03.012
  34. Gupta NK, Agrawal RK, Srivastav AB, et al. Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease. Lung India 2011;28(2):105–109. DOI: 10.4103/0970-2113.80321
  35. Huang YS, Feng YC, Zhang J, et al. Impact of chronic obstructive pulmonary diseases on left ventricular diastolic function in hospitalized elderly patients. Clin Interv Aging 2014;10:81–87. DOI: 10.2147/CIA.S71878
  36. Caram LM, Ferrari R, Naves CR, et al. Association between left ventricular diastolic dysfunction and severity of chronic obstructive pulmonary disease. Clinics (Sao Paulo) 2013;68(6):772–776. DOI: 10.6061/clinics/2013(06)08
  37. Jatav VS, Meena SR, Jelia S, et al. Echocardiographic findings in chronic obstructive pulmonary disease and correlation of right ventricular dysfunction with disease severity. IJAM 2017;4(7):476–480. DOI: 10.18203/2349-3933.ijam20171045
  38. Maula F, Nadeem M, Adil M, et al. Echocardiographic findings in chronic pulmonary disease (COPD) patients. PJCM 2012;2309–9844.
  39. Hilde JM, Skjørten I, Grøtta OJ, et al. Right ventricular dysfunction and remodeling in chronic obstructive pulmonary disease without pulmonary hypertension. J Am Coll Cardiol 2013;62(12):1103–1111. DOI: 10.1016/j.jacc.2013.04.091
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.